元认知心理干预技术联合文拉法辛对首发抑郁症患者执行功能的影响——来自行为学和ERPs的证据

Effect of conditioned emotional response intervening technique combined with venlafaxine on executive function in patients with first-episode depression:Evidence from praxeology and ERPs

目的探讨元认知心理干预技术联合药物对首发抑郁症患者执行功能的影响。方法将60例抑郁症患者随机分为研究组和对照组,分别进行8周的元认知心理干预技术联合药物治疗或单纯药物治疗,于治疗前和治疗后采用24项汉密尔顿抑郁量表(HAMD-24)、Go/Nogo任务、Stroop任务及事件相关电位(ERPs)评估患者的抑郁症状和执行功能的变化。结果治疗后两组HAMD-24总分均较治疗前降低(P<0.001),治疗后研究组HAMD-24总分低于对照组(P<0.05)。治疗后两组Nogo条件的正确应答数均较治疗前升高(P<0.01),Stroop测验不一致条件的反应时较治疗前减少(P<0.01);研究组Stroop测验中不一致条件反应时短于对照组(P<0.05)。治疗后两组较各自治疗前诱发了更大的Nogo N2波幅和Nogo P3波幅(P<0.05),研究组的N2差异波波幅和P3差异波波幅大于对照组(P<0.001)。结论元认知心理干预技术联合药物可以更有效改善患者的抑郁症状,对抑郁症患者的执行功能具有调节作用。

Objective To explore the effect of conditioned emotional response intervening technique combined with medication on executive function in patients with first-episode depression.Methods 60 patients with depression were randomly divided into study group and control group,and received conditioned emotional response intervening technique combined with medication or medication therapy alone for 8 weeks.All the patients were assessed with Hamilton Depression Scale(HAMD-24),Go/Nogo,Stroop and event-related potentials(ERPs)before and after treatment.Results After treatment,the total scores of HAMD-24 significantly decreased in both groups compared with those before treatment(P<0.001),and the total score of HAMD-24 in study group was significantly lower than that in control group(P<0.05).In the Go/Nogo test,the numbers of correct responses to Nogo condition significantly increased in both groups after treatment compared with those before treatment(P<0.01).In the Stroop task,under the inconsistent condition,the response time obviously decreased in both groups after treatment compared with those before treatment(P<0.01),and the response time in study group was significantly shorter than that in control group after treatment(P<0.05).In ERPs indexes,both groups induced larger amplitudes of Nogo N2 and Nogo P3 after treatment(P<0.05).Compared with control group,the study group induced larger amplitudes of N2 difference wave and P3 difference wave(P<0.001).Conclusion Conditioned emotional response intervening technique combined with medication can effectively improve the depressive symptoms,and regulate executive function in patients with depression.